目的 探讨妊娠糖尿病(gestational diabetes mellitus,GDM)的相关危险因素及对母婴结局的影响.方法 回顾性分析2011年3月31日至2016年10月31日于本院住院分娩的1281例GDM孕/产妇(GDM组)以及同期1281例正常孕/产妇(正常组)的临床资料,分别记录孕/产妇的年龄、孕次、产次、孕前体重指数(body mass index,BMI)、体重增加值、是否有糖尿病家族史等,分析GDM的危险因素以及对母婴结局的影响.结果 GDM患病率为17.1%,首诊漏诊率为82.2%.单因素分析结果显示:年龄、孕次、孕前BMI、糖尿病家族史是影响GDM的高危因素(P<0.01).多因素分析结果显示:孕前BMI、糖尿病家族史、年龄是影响GDM的独立危险因素.GMD组孕妇平均孕周为(38.57±1.46)周,正常组平均孕周为(38.92±1.26)周,两组比较差异具有显著性(P<0.05).GDM组孕/产妇羊水过多、妊娠期高血压疾病、胎儿宫内窘迫发生率及巨大儿出生率均明显高于正常组(P<0.05).结论 GDM首诊漏诊率较高;孕前BMI、糖尿病家族史、年龄是GDM的独立危险因素;GDM孕/产妇分娩孕周缩短,羊水过多、妊娠期高血压疾病、胎儿宫内窘迫发生率以及巨大儿出生率均升高.%Objective To discuss the risk factors of gestational diabetes mellitus (GDM) and effects on mother-infant prognosis. Method The clinical data of 1281 patients with GDM (GDM group) and 1281 cases normal gravida/parturient (normal group) from March 31, 2011 to October 31, 2016 in our hospital were analyzed. Maternal age, gravidity, parity, pregestational body mass index (BMI) pregnancy weight gain, whether there was a family history of diabetes were recorded. Risk factors of GDM and effects on mother-infant prognosis were analyzed. Result The prevalence rate of GDM was 17.1%, and the missed diagnosis rate was 82.2%. Single factor analysis showed that age, gravidity, pregestational BMI, and family history of diabetes were the risk factors of GDM (P < 0.01). Multivariate analysis showed that pregestational BMI, family history of diabetes and age were the independent risk factors of GDM. The average gestational weeks were (38.57±1.46) weeks in GMD group, normal group were (38.92±1.26) weeks, there was significant difference between the two groups (P < 0.05). In GDM group, the incidence rate of apolyhydramnios, hypertensive disorder complicating pregnancy, fetal distress and fetal macrosomia birth rate were significantly higher than those in normal group (P < 0.05). Conclusion GDM first diagnosis misdiagnosis rate is high; pregestational BMI, family history of diabetes, age are the independent risk factors of GDM; pregnant women with GDM pregnant week is shortened, and polyhydramnios, hypertensive disorder complicating pregnancy, fetal distress, macrosomia incidence increase.
展开▼
